OBJECTIVE: To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND: Increasing evidence points to the importance of the postoperative or ward-based phase of surgical care in determining patient outcomes. Ward-based care is determined by the clinician ward round, with the simulated ward environment potentially providing a safe environment for training and assessment. METHODS: A high-fidelity surgical ward environment was developed. Junior and senior trainees conducted ward rounds of 3 standardized surgical patients and were assessed using a checklist of assessment and management care processes, modified NOTECHS score, and fidelity questionnaire. RESULTS: Nine senior and 9 junior trainees were observed. There was no significant difference in time taken to conduct the round (37.6 ± 2.7 vs 32.6 ± 1.9 minutes, P = 0.16). Senior trainees performed significantly more assessment processes (73% ± 2.8% vs 63% ± 2.5%, P = 0.016) and completed more management tasks (73% ± 4.5% vs 59.4% ± 5%, P = 0.058). Fifteen adverse events were committed by junior trainees versus 8 by seniors (P < 0.001). Seniors scored higher on nontechnical ability (NOTECHS score 21.8 ± 0.61 vs 18.1 ± 1.12, P = 0.017). All of subjects felt the ward, patients, and scenarios were realistic. CONCLUSIONS: A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.
OBJECTIVE: To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND: Increasing evidence points to the importance of the postoperative or ward-based phase of surgical care in determining patient outcomes. Ward-based care is determined by the clinician ward round, with the simulated ward environment potentially providing a safe environment for training and assessment. METHODS: A high-fidelity surgical ward environment was developed. Junior and senior trainees conducted ward rounds of 3 standardized surgical patients and were assessed using a checklist of assessment and management care processes, modified NOTECHS score, and fidelity questionnaire. RESULTS: Nine senior and 9 junior trainees were observed. There was no significant difference in time taken to conduct the round (37.6 ± 2.7 vs 32.6 ± 1.9 minutes, P = 0.16). Senior trainees performed significantly more assessment processes (73% ± 2.8% vs 63% ± 2.5%, P = 0.016) and completed more management tasks (73% ± 4.5% vs 59.4% ± 5%, P = 0.058). Fifteen adverse events were committed by junior trainees versus 8 by seniors (P < 0.001). Seniors scored higher on nontechnical ability (NOTECHS score 21.8 ± 0.61 vs 18.1 ± 1.12, P = 0.017). All of subjects felt the ward, patients, and scenarios were realistic. CONCLUSIONS: A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.
Authors: Pritam Singh; Rajesh Aggarwal; Philip H Pucher; Daniel A Hashimoto; Laura Beyer-Berjot; Rasiah Bharathan; Katherine E Middleton; Joanne Jones; Ara Darzi Journal: Surgery Date: 2015-01-26 Impact factor: 3.982
Authors: Bhavesh Patel; Maximilian Johnston; Natalie Cookson; Dominic King; Sonal Arora; Ara Darzi Journal: J Med Internet Res Date: 2016-04-06 Impact factor: 5.428